Comparative Diagnostic Efficacy of Ultrasonography and Radiography for Gas Embolism in Loggerhead (Caretta caretta) Turtles

Sea turtles face numerous threats, often stemming from human activities, resulting in high mortality rates. One of the primary risks they encounter is posed by fishing activities. In the South Adriatic Sea, the extensive trawling fleet often impacts sea turtles, and in recent years, a specific disorder, known as gas embolism (GE), and the associated disease known as decompression sickness (DCS), has emerged as a new threat. Our study aims to compare the statistical concordance and sensitivity, specificity, and accuracy between ultrasonography and radiography for evaluating GE in marine turtles. The study involved the analysis of 29 loggerhead turtles (Caretta caretta) admitted to the Sea Turtle Clinic (STC) at the Department of Veterinary Medicine, University of Bari, Italy, between December 2022 and March 2023. The sea turtles underwent X-ray evaluation using the three standard projections (dorso-ventral, latero-lateral, cranial-caudal), followed by ultrasound examination to visualize blood vessels through cervical, axillary, and inguinal ultrasound windows. Color Doppler ultrasonography was utilized to assess blood flow, gas localization, and quantity, but this technique proved to be less helpful in detecting GE. Our results confirm the statistically valid performance of ultrasonographic examinations, highlighting the significant role of combining ultrasonography and radiography to enhance sensitivity, especially in complex and challenging cases for identifying gas embolism (GE) in sea turtles.